Nonresidents of that district still on the hook to pay up

Fire medic Drew Yamamoto prepares Thursday to leave for a training session on Rocky Mountain Fire Station 6's ambulances in Eldorado Springs. A change to Rocky Mountain Fire Protection District's billing policy means residents in its special taxing district will no longer be responsible for ambulance fees beyond what their health insurance covers. (Paul Aiken / Staff Photographer)

A billing policy change at Rocky Mountain Fire Protection District that went into effect Wednesday will ease the financial burden on residents who receive emergency medical transportation by ambulance.

The district — which serves about 30,000 residents spanning a 65-square-mile area south and east of Boulder from Rocky Flats up to the city's northern edge — is no longer billing district taxpayers for ambulance service costs not covered by their health insurance plans.

Part of the reason such a policy is fiscally viable for Rocky is its medical calls often serve people from outside the district boundaries who are injured or suffer an emergency while exploring the myriad mountain trails in the area or while commuting on U.S. 36.

Those clients still will get a bill for its ambulance transportation.

The new policy represents a philosophical shift in who bears the burden of funding emergency medical services away from models used by other agencies in Boulder County — Rocky has opted to spread the cost among its tax base, while nearby departments expect the individuals receiving the service to pay a portion of their own cost.

"The provision of our ambulance service is not based on what we collect (from patients)," Rocky emergency medical services Capt. Paul Johnson said.

Collecting costs from patients remains crucial to neighboring fire and emergency medical services, although some have found ways to reduce the bills sent to residents of charges remaining after health insurance contributions.

Advertisement

Since 2006, Louisville Fire Department, which is also funded through a special district tax, has allowed residents to register for an "ambulance membership program," which charges individuals $25 per year and families $65 per year so that if any registrants require an ambulance, they are not billed anything following their insurance plan's contribution.

The program has 60 participants, Louisville Fire Chief John Willson said.

"Our philosophy is the person who's using the service should be paying a little bit, instead of passing that onto everyone," Willson said. "At this time, we are not considering (a no-billing policy like Rocky's) at all."

An estimate of the loss Rocky will incur as a result of not billing taxpaying residents for ambulance services amounts to about $40,000 annually, Deputy Chief Sterling Folden said.

That is far exceeded by the money collected from nonresidents of the district who receive its medical services, according to Chief Mike Tombolato, although Rocky officials Thursday could not provide an exact revenue figure generated by those calls or break down the numbers of residents versus nonresidents who receive ambulance service.

The district fields about 1,500 calls per year, and 70 percent of them involve an emergency medical component, Tombolato said.

Its 2018 operating budget is about $8.5 million, but collections on medical bills previously sent to residents — as well as nonresidents served by the district — were not allocated toward that fund in favor of using them to feed Rocky's capital improvement fund for upgraded fire, ambulance and rescue vehicles.

"The way we've always viewed it is the ambulance is a supplementation to the fire department. When we go out and get our tax base, we base those dollars on what it takes to staff and manage the apparatus we have," Folden said.

Reimbursements from many insurance providers for emergency medical services often leave a shortfall between the cost of staffing and outfitting an ambulance crew.

Folden said ambulance services can normally recover about 40 percent of their costs through collections from both insurance providers and the patients served, with 70 percent of what's collected coming from insurance.

But Rocky now intakes enough revenue through its mill levy — which was the largest of fire districts in Boulder County last year at 20.445 mills, and remains near that this year at 19.325 mills — to cover the gap left by the health insurance plans of district residents. A resident who owns a $500,000 home would be billed $695.70 for the property tax that funds the fire protection district at the current mill rate.

"When you get down to the percentage paid by residents, it's a good size of money to them, but (not) in the overall system, the (district) system," Folden said. "We feel it's a bigger benefit to the citizen on an individual basis where they can put $1,200 or $800 or $500 bucks in their pocket because then they can buy groceries and pay their rent and pay the electric bill, whereas overall to us finally we've gotten to a spot where ... we can absorb some of this impact."

This week's addition of a second ambulance to Rocky's fleet also prompted the policy change, which Folden said had been considered for several years.

"Now that we have added an additional ambulance, we felt that we are now serving a large enough area to make the policy impactful," he said.

He anticipates the new policy will remain unique to Rocky.

"I wouldn't expect to see this catch fever and start running with it to be honest with you. It's revenue loss, and (agencies) don't want to do that," he said.

Senior, Cougars coming off runners-up finishes last seasonNIWOT — In terms of overall numbers, this year's Niwot gymnastics team will be smaller than usual, but that hasn't stopped the Cougars from setting their sights as high as possible. Full Story

The Boulder alt-country band gives its EPs names such as Death and Resurrection, and its songs bear the mark of hard truths and sin. But the punk energy behind the playing, and the sense that it's all in good fun, make it OK to dance to a song like "Death." Full Story